S&C QCOR HHA 2567s
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HHAs 2567s
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Time Interval

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Provider Characteristics

Use these filters if you want to limit the report to providers that have certain characteristics. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

Survey Type & Deficiency Tags

Use these filters if you want to limit the reports to providers on specific survey types, or to reports that were cited for specific HHA deficiency tags and tag types. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

CCN and Facility Name

Use these filters if you know the name (or partial name) of the facility you are searching for, or the CMS Certification Number (CCN) for the facility you are searching for.

Other Survey Characteristics

Select one of the options below to filter by surveys that cite deficiencies or by surveys that are deficiency-free. By default, only surveys that cite deficiencies are displayed. Selecting "All" displays all surveys.

CMS Certification Number Facility Name Address City State CMS Region Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
▼ 147785 Guardian Home Health Care, Llc 181 Waukegan Rd, Ste 301 Northfield IL 5 (Chicago) 06/08/2023 5FF7F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0414 HHA administrator contact information Element
G0434 Participate in care Element
G0622 Name/contact information of clinical manager Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 147785 Guardian Home Health Care, Llc 181 Waukegan Rd, Ste 301 Northfield IL 5 (Chicago) 08/20/2020 V50K11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0808 Onsite supervisory visit every 14 days Element
▼ 147786 Metropolitan Home Health Care, Inc 340 E Dundee Road Wheeling IL 5 (Chicago) 11/25/2020 74DX11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0586 Review and revision of the plan of care Standard
G0684 Infection control Standard
G1014 Interventions and patient response Element
▼ 147788 Compassionate Home Care, Inc 11118 S Kedzie Avenue Chicago IL 5 (Chicago) 03/12/2020 J0ZQ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0434 Participate in care Element
▼ 147791 Atlas Healthcare Management, Inc 5658 W Ohio St Suite 2e Chicago IL 5 (Chicago) 11/29/2021 37DD5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
G0982 Skilled services furnished Standard
G0772 Documentation of competency evaluation Element
G0952 Ensure that HHA employs qualified personnel Element
G0954 Ensures qualified pre-designated person Element
▼ 147791 Atlas Healthcare Management, Inc 5658 W Ohio St Suite 2e Chicago IL 5 (Chicago) 01/22/2019 GBHJ12 Recertification
Deficiency Tag Deficiency Description Tag Type
G0978 Must have a written agreement Element
▼ 147791 Atlas Healthcare Management, Inc 5658 W Ohio St Suite 2e Chicago IL 5 (Chicago) 12/06/2018 GBHJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0570 Care planning, coordination, quality of care Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0029 Development of Communication Plan Standard
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0942 Governing body Standard
G1010 Contents of clinical record Standard
G1024 Authentication Standard
G0414 HHA administrator contact information Element
G0444 State toll free HH telephone hotline Element
G0550 At discharge Element
G0588 Reviewed, revised by physician every 60 days Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 147794 Assure Home Healthcare, Inc 28140 N. Bradley Rd Libertyville IL 5 (Chicago) 06/06/2023 5FF91-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0706 Interdisciplinary assessment of the patient Element
▼ 147795 Laketop Inc 16250 Louis Ave, Ste 1 South Holland IL 5 (Chicago) 10/27/2023 61289-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G1024 Authentication Standard
▼ 147795 Laketop Inc 16250 Louis Ave, Ste 1 South Holland IL 5 (Chicago) 12/03/2020 S6X311 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0684 Infection control Standard
G0574 Plan of care must include the following Element
G0622 Name/contact information of clinical manager Element